Unexpected consequences are often the bane of a policymaker’s existence.  Sometimes, though, what you don’t expect actually turns out well.

The move toward patient centered medical homes has been largely driven by the desire to improve patient outcomes and for providers to take advantage of incentive money to help fund IT upgrades, says Michael Meucci, a director with healthcare consultant firm Arcadia Solutions.

“But what’s often forgotten,” he says, "is that pursuing PCMH certification involves a total cultural and organizational change."

[See also: How to get 3 steps closer to PCMH.]

That, he says, has led many providers to realize benefits they hadn’t really anticipated.

1. Better integration of clinical IT into practice workflow -- According to Meucci, pursuing PCMH certification creates an opportunity for providers to rethink their use of IT with the goal of maximizing its use in patient management. Some PCMH standards require providers to report how many patients are missing appointments, for example, which in turn forces them to rethink the process they’re using to capture and make use of patient information.
2. Happier patients . . . Really! -- Another part of the PCMH transformation involves measuring patient satisfaction, and for many providers one of the keys to increasing satisfaction, Meucci said, is expanding the access patients have both to their doctors and their own health information. Better use of IT enables providers to reduce scheduling barriers, provide post-visit summaries, and reduce wait times, all of which impact how patients perceive their physicians.
3. Better formal decision making framework -- While not directly related to IT, it’s not hard to see how better decision-making is likely to lead to more efficient and effective use of IT.  And, according to Meucci, a big part of PCMH transformation, particularly for multi-clinic organizations, involves the development of formal governance structures that constitute a forum for decision-making that helps organize and unify network practices
4. Increased practice productivity -- So you wanted to do the right thing by improving patient care. And you wanted to help your bottom line by qualifying for applicable incentives. And along the way you ended up becoming more productive. Meucci acknowledged, the implementation of PCMH is hard, but the results of better IT integration and better care team utilization, once implemented, allow practices to see more patients, reduce wait times and deliver better care. He added that part of the productivity increase providers realize is related to, through more proactive patient outreach and management, keeping patients coming to primary care centers as opposed to waiting too long and ending up in the emergency room.  

[See also: Technology plays pivotal role in PCMH demos.]

So how long does it take before providers begin to realize the benefits they weren’t expecting in the first place?

According to Meucci, while there may be early indicators, things really begin looking up after about the 12 month point in a practice transformation.  “You have to convince people it’s going to work,” he said, adding that practices should start with the easy things first, then move to the more complicated parts of the process.